Mendocino County exploring its emergency medical services options

An idea that could bolster the system that sends the first people on scene in a medical emergency -- whether it's a heart attack, a car accident or a shooting -- is being explored after a 2011 study identified areas of weakness in the system.

The Mendocino County Board of Supervisors in May 2009 commissioned a study of the county's emergency medical services system, and in June 2011 heard recommendations from its consultant, Fitch & Associates of Platte City, Mo. The study found that training, consistency of standards and funding were lacking, and fire departments that send emergency medical technicians to rural areas were grappling with lengthy response times and possible failure.

"Nothing has really changed since 2011," said David Grim of the Mendocino County Executive Office during the Tuesday update.

Since then, he said, the idea of creating a parcel tax to fund the system came up but didn't happen. Now, he said, the county and its EMS overseer, Coastal Valleys EMS Agency, are exploring an alternative.

The Tuesday report focused on the idea of forming an exclusive operating area for its EMS response countywide, a move its proponents hope will save money and create more consistent standards of service.

While it's not clear what the operating area would look like -- or whether there would be more than one within the county -- the idea would be to have one contractor be responsible for EMS response in a given area, according to James Salvante, EMS coordinator with Coastal Valleys EMS Agency.

In part, that would mean cutting down on the duplication of administrative tasks that multiple responding agencies each perform within that area, he said. It would also mean the level of services and training each agency provides would be consistent and upheld via contract, with one contractor subcontracting with responding agencies in the area.

The idea, according to Salvante, would be to make the system financially sustainable and organizationally stronger.

Concerned about what a franchise arrangement would do to the agencies that currently provide EMS response, 3rd District Supervisor John Pinches asked how such a structure would interact with the volunteers at various fire departments.

"We are not going to have a sustainable system without incorporating the volunteers," said Dr. Mark Luoto, medical director with Coastal Valleys EMS Agency.

Grim said a feasibility report on the concept was under way, and is expected to go before the Board of Supervisors in mid-May. If the board approves it, the exclusive operating area wouldn't become effective for "some months after that," he said.

"This county's larger than some states," Pinches said, calling the two-month time frame "ambitious." He expressed concern that if the idea is approved, "you will give those volunteers a boss that's not the community ... and volunteerism is going to drop off."

Grim said the next few months will involve getting input back from stakeholders -- including the current responding agencies -- and holding "town hall" style meetings.

Board chairman 5th District Supervisor Dan Hamburg urged the working group to reach out to fire departments that might not be able to attend the meetings because of short staffing, but would likely be no less interested in making the county's EMS system sustainable.

Second District Supervisor John McCowen and 1st District Supervisor Carre Brown echoed their colleagues' concerns, and also urged the group to put more emphasis on involving all EMS agencies countywide in the process than on having something ready for the board to vote on by May.

Tiffany Revelle can be reached at udjtr@ukiahdj.com, on Twitter @TiffanyRevelle or at 468-3523.